343 ng / dL test but my doctor says this is normal

[Kambrook]

Hi all,

I have taken three seperate blood tests over the past couple of years. All have indicated both low T and low FSH - suggestive of secondary hypogonadism. Yet my doctor insists these results are completely normal and refuses to refer me to an endocrinologist (you can't get seen by them without a referral). Here are the results of my most recent test:



The others were even worse than this. I have all the usual symptoms - lethargy, lack of morning erections, inability to gain muscle mass or lose weigh, etc. I don't know what to do. Do I just keep switching doctors hoping I'll eventually stumble upon one who'll take my case seriously?

I've been wondering if I should just self-medicate. I know getting hypogonadism from incorrect usage of steroids is a common concern, but in my case it really doesn't seem like I have anything to lose. Even if, by some miracle, I did manage to find a sympathetic doctor and got on TRT they'll probably play it really conservatively and just bump me up to 450-500 ng / dL. Ideally, I'd like to be at 1000+ ng / dL so I can build some decent muscle mass.

The other thing is that I think I may have gynecomastia. The doctor fondled my "breasts" and concluded that I don't have it, but considering that he also thought my ~300 ng / dL test was "perfectly normal" I don't know if I trust his judgement. Given the results above, do you think I likely have gyno? It's either that or a lot of fat stored in the upper chest. I mean, I'm not sure if there's a glandular component to it or not. If I push my finger down hard around my nipple I can feel this rubber donut type thing about an inch in diameter. But I never experience any pain or discomfort around the area. I really want to resolve this issue (either through lipo or a full male breast reduction operation) but I don't want to do it if it's just going to come right back due to my hormonal situation.

Thanks in advance for any advice.

[almostgone]

I would start shopping around for a new Dr. It's frustrating and can take time, but I think it would be well worth the effort. I had to shop around for several years due to my health history, but I am glad I did.

[almostgone]

Have you checked the A4M directory to see if there is a Dr. in your area?
Also, some of the guys on here have really good GPs that handle both.their general health issues and TRT.

[kelkel]

How old are you? Height, weight, estimated BF%?
Hormone testing should be done first thing in the morning for endogenous levels.
Always check free T as well as it's what works for you.

Your LH level is appears fine so the issue seems to be more primary in nature from what I see. It can be a combination of both primary and secondary though. I'd probably be interested in a testicular ultra-sound or palpation to check for varicoceles. If none are found another thought may be an HCG Stimulation Test to determine function of your testicals. Google it.

Re gyno. Is it hard and fibrous? If not it's probably more fat build up than anything else. You can look into SERM therapy. Check the Educational Articles Database in the AAS Q & A Forum as there's a thread on that topic.

[Kambrook]

Have you checked the A4M directory to see if there is a Dr. in your area?
Also, some of the guys on here have really good GPs that handle both.their general health issues and TRT.

Thanks. I checked it but there aren't any in my city unfortunately.

[Kambrook]

How old are you? Height, weight, estimated BF%?
Hormone testing should be done first thing in the morning for endogenous levels.
Always check free T as well as it's what works for you.

Your LH level is appears fine so the issue seems to be more primary in nature from what I see. It can be a combination of both primary and secondary though. I'd probably be interested in a testicular ultra-sound or palpation to check for varicoceles. If none are found another thought may be an HCG Stimulation Test to determine function of your testicals. Google it.

Re gyno. Is it hard and fibrous? If not it's probably more fat build up than anything else. You can look into SERM therapy. Check the Educational Articles Database in the AAS Q & A Forum as there's a thread on that topic.

I'm 30, 6' 1'', 190 lbs. Probably just over 20% bf (starting to show love handles and a gut).

Correct me if I'm wrong, but my understanding is that my brain isn't sending enough of a signal (i.e., FSH) to my testes to produce testosterone rather than a problem with the testes themselves? One thing I forgot to mention is that my semen has a kind of yellow tone to it.

Regarding gyno, I found a thread which suggests 60 mg Raloxifene and 40 mg Tamoxifen daily. Do you think this could work for me?

I wouldn't say it's hard and fibrous really. But I understand most cases of gyno have at least a small glandular component present?

Thanks very much for your advice.

[kelkel]

LH is responsible for test production. FSH for sperm. Your LH signal is good, you FSH is below scale. Question is why.
Re gyno. Read Austinites link I referenced. Ralox is statistically better (by a couple percentage pts) than Nolva. You do not need both, only one. Before I'd start any therapy I'd consider losing some more BF and reassessing.

[SweepTheLegJohnny]

Just keep searching around until you find a sympathetic GP. Many aren't going to touch hormone therapy at 343 but there are some that will listen to you. Mine were right around that level (320) when I first started looking for TRT but my LH levels were very low, I was honest and told them I had used AAS and prohormones when I was younger and they were receptive.

Be prepared to be frustrated though... The "most respected endo" in the area saw that bloodwork showing crashed LH and total test at 290 and he basically said "you're fat" and charged me $500 anyway.